Could the onset or rapid worsening of diabetes be an early sign of pancreatic cancer?

According to a study presented at the 2017 European Cancer Congress, sudden-onset diabetes or rapid worsening of existing diabetes requiring more intensive treatment may be an early sign of underlying, hidden pancreatic cancer.

Pancreatic cancer lacks typical signs for early diagnosis and is therefore most often diagnosed at stage 4. Many biomarkers are being investigated, and some studies show findings suggesting a connection between blood glucose levels and pancreatic cancer.

Pancreatic cancer is known to be difficult to treat, with shorter survival than other cancers. It is the 4th leading cause of cancer-related death in the United States. Its poor reputation largely reflects its rapid, insidious progression with few symptoms. Unfortunately, we lack an important early-detection marker for such a serious disease, although much scientific research is underway.

Study

Presented at the 2017 European Cancer Congress, the study used prescription data from Belgium and Italy between 2008-2013. It examined type 2 diabetes, also known as adult-onset diabetes, in approximately 1 million patients in relation to pancreatic cancer, with striking results. Among those followed, half of patients diagnosed with pancreatic cancer, within the first 1 year, had received a diagnosis of type 2 diabetes.

In the first group in both countries, %50 of pancreatic cancer patients had type 2 diabetes diagnosed and received their first prescription within 1 year before pancreatic cancer diagnosis. In Belgium, %25, and in Italy, %18, were diagnosed with pancreatic cancer within the first 90 days.

Another group had preexisting type 2 diabetes treated with oral antidiabetic tablets. Among those whose blood glucose control worsened and whose prescriptions added incretin (a metabolic hormone increasing insulin secretion) and insulin, pancreatic cancer risk in the first 90 days was 3.5 times higher than with oral antidiabetics. This increased risk declined over time. During the first 1 year, at 3-6 months it was 2.3 times higher; at 6-12 months, 2 times higher; and after 12 months, 1.7 times higher. Additionally, patients whose diabetes worsened rapidly and who required more intensive insulin for glucose control had a 7-fold higher risk of finding pancreatic cancer.

Although the second group’s results might appear to suggest incretin or intensive insulin causes pancreatic cancer, the correct interpretation is that pancreatic cancer worsens diabetes.

Many risk factors have been associated with pancreatic cancer. Type 2 diabetes, along with smoking and obesity, is one of its 3 most important causes. Although type 2 diabetes has been found to increase pancreatic cancer risk nearly 2-fold, the relationship remains complex. Alongside the cancer-promoting effects of diabetes and metabolic burden, pancreatic cancer may trigger diabetes: a two-way relationship is accepted. Unfortunately, distinguishing pancreatic cancer-related diabetes from the more common type 2 diabetes is difficult.

Conclusion

Optimal pancreatic cancer screening strategies and methods have not yet been fully established. This study suggests that new diabetes or rapidly worsening glucose control may provide clues to early pancreatic cancer diagnosis. Although promising, this association does not apply to every patient. Further research is clearly needed. .

What is Type-2 Diabetes, and how does it develop?

Type 2 diabetes mellitus, also known as adult-onset diabetes, is characterized by hyperglycemia (high blood sugar), insulin resistance and impaired insulin secretion. Its frequency is rising markedly alongside increasing obesity and sedentary lifestyles.

The main task of insulin secreted by the pancreas is to mediate movement of blood glucose into tissues. Excess glucose entering the blood from the digestive system through overconsumption is counterbalanced by increased pancreatic insulin secretion. If prolonged, the pancreas secretes insulin more frequently. Eventually, tissues develop insulin resistance, less blood glucose enters tissues, and blood sugar remains high, producing diabetes.